By Sue Facter, Spotlight Health
With medical adviser Stephen A. Shoop, M.D.
Mr. Blackwell has an eye for fashion. But the man who originated Hollywood's Best and Worst Dressed lists couldn't believe what he saw in the mirror when Bell's Palsy (BP) struck without warning. 'The left side of my face drooped,' says Blackwell. 'Saliva ran down it. It just happened.'
Luckily, the fashionista had dinner plans with his internist, Dr. Glen Hollinger of Good Samaritan Hospital, who immediately recognized the symptoms of BP.
Blackwell's shocking experience is common for those stricken by BP - a sudden yet temporary weakening or paralysis of the facial muscles - that afflicts about 40,000 Americans annually. Internationally, the frequency is about 1 out of every 5,000 people.
BP is most common between ages of 30 and 60 and strikes men and women equally. Approximately half of BP patients completely recover in a short period of time. And another 35% have good recoveries within a year. The recurrence rate is between 10 and 20%.
While the cause of BP is unknown, most scientists believe that BP results from a viral infection that inflames the facial nerve. The swelling that accompanies the inflammation damages the nerve, impairing its ability to transport signals to the facial muscles and saliva and tear glands.
Other conditions possibly leading to Bell's Palsy include:
· Viruses like Epstein-Barr, mumps and rubella, cytomegalovirus, and herpes simplex 1
· Immune system diseases
· Facial and surgical wounds
· Trauma due to a blunt force
· Brain stem injuries
· Diabetes - Quadruples risk compared to the general public
· Temporal bone fractures
· Pregnancy - The last trimester increases the risk for BP
'It can come from many sources,' says Dr. Murray Grossan, an otolaryngologist at Cedars Sinai Medical Center in Los Angeles. 'It a can be a plain old virus that happens to settle there. It could be an infection, or it can just be like a herpes virus. But it's not a sexually transmitted disease.'
Symptoms and treatment
Physicians first rule out other conditions that can cause facial-nerve weakness such as ear infections, herpes-zoster infection (shingles), Lyme disease, meningitis, multiple sclerosis and stroke.
Blackwell underwent extensive tests at Good Samaritan before Hollinger diagnosed him with mild BP.
Other BP symptoms include:
· Facial muscle weakness/paralysis
· Inability to close eye
· Difficulty eating or drinking
· Pain in or behind the ear
· Diminished or distorted taste
· Sensitivity to light
· Drooling
Most often, BP is not life-threatening, and usually clears up on its own. Blackwell had BP for about six months.
Once patients are diagnosed, doctors have limited options when treating BP. 'Dr. Hollinger said there was nothing he could do,' says Blackwell.
'This disease has been around a long time,' says Hollinger. 'Prednisone was prescribed for his initial outbreak, to calm the inflammation. Unfortunately, there's not much more we can do these days.'
Grossan adds that in addition to prednisone, he prescribes papaya enzymes, which act as an anti-inflammatory. Grossan says he treated his own daughter for BP. 'You suck on the enzyme four times a day and it takes down the inflammation,' he says.
'We can't clear the condition totally, because the nerve has been damaged,' says Grossan, who recently co-authored The Sinus Cure. 'Some of it may be an autoimmune disease, we don't know. But usually it's dealt with like a virus. We use viral medications (Zovirax) and usually throw it on top.'
Grossan also suggests biofeedback exercises in front of the mirror to try to make the bad side match the good side. 'If there's no improvement, try electrical stimulation.'
Grossan's daughter lucked out because she called her father immediately. 'We treated it right away and she was only afflicted for a week,' says Grossan.
Blackwell wasn't as lucky. For three months, he could not swallow food and experienced a vocal cord problem that still occasionally afflicts him. Blackwell's eyesight also has been affected. But that doesn't stop him from driving locally, though he avoids the Southern California freeways. 'I go to the market; I've got to.'
He also experiences momentary vertigo. 'I miss a step. The left hand still drops things.' 'Something was taken from me,' says Blackwell. 'I ran a circle that has cocktail/dinner parties. For six months, I didn't go anywhere. I really wanted to see people, but it was no fun anymore. They said time is the answer.'
Time did indeed heal Blackwell. He's out on the party circuit again, but tires easily. 'I love going out; that's my life,' he says.
Because of his affliction, Blackwell did not have a formal press conference last January for his 'List.' But with the support of Robert Spencer, who Blackwell calls his 'lifeline,' he is already compiling his next list.
'I'll be back in January!' he says.
Mr. Blackwell Dresses Down Bell's Palsy
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